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Affordable Care Act

Multiple-Employer Welfare Arrangements (MEWA) a Healthcare Alternative

Multiple-Employer Welfare Arrangements (MEWA) a Healthcare Alternative

Multiple-Employer Welfare Arrangements, or MEWAs, are growing in popularity as another alternative to traditional health insurance policies. The Affordable Care Act’s mandate requires a broader range of employers to cover their employees’ healthcare costs. MEWAs are an alternative healthcare option to the federal health insurance exchanges.

MEWAs are a kind of self-funded insurance plan. MEWAs are put together by a group of employers who don’t want to work within the governmental healthcare system. A self-funded MEWA allows a group to get together to pool their health care resources, rather than strike out on their own to fund their health insurance needs individually.

Benefits of MEWAs

MEWAs are beneficial to employers because they allow for risk to be spread to a number of entities, rather than be shouldered by one small business. MEWAs can be used to offer health care incentives to employees or members of a professional association. If a small business doesn’t want to use the existing federal health insurance marketplace in order to provide health insurance for their employees, this can be a viable alternative.

MEWAs are member-owned, meaning the benefits flow around to all the people who are involved in the program. Employers who offer a MEWA health insurance plan are able to keep deductibles and premiums stable while still offering full healthcare coverage to their employees. Profits from the MEWA stay within the group that started the MEWA, so the savings and the risks are spread around.

Many MEWAs are set up like a board of trustees. This means that there is no artificial inflating of health insurance costs and that your payments don’t have to change year to year. If an employer is offering up incentives for their employees in the form of a wellness program, that positive action comes back around in the form of healthier employees and even lower insurance costs. If employees sign on to the MEWA program but don’t use it very often, costs are decreased for everyone.

A board of trustees is usually set up to manage the MEWA, which allows changes and alterations to be made to the program to account for the specific needs of the group that is being insured. This ensures a stability that doesn’t always exist in traditional insurance plans, because people are in control of the costs and not the insurance market.

Although small businesses can benefit from MEWAs, other organizations large and small can create a MEWA, too. Individuals, large groups, and professional associations are also eligible for this kind of insurance program.

What to know about MEWAs

There are some states in the US that allow MEWAs, while others do not. Other states may regulate MEWAs strictly. Although too many restrictions can harm the functioning of a MEWA, a level of regulation isn’t a bad thing. This keeps MEWAs for the people, businesses, and organizations that can benefit from them the most and use them properly.

When determining your eligibility for a MEWA, your state’s laws regarding this kind of insurance plan will need to be checked. If your state does allow MEWAs, this can be an incredibly helpful opportunity for you and your employees.

MEWAs are member-owned, so the rewards and the risk are contained in that particular group of employers or associated organizations. This allows for a dissemination of pressure if there are a lot of claims one year and not the next. A MEWA is set up to be regulated, but also to give employers the ability to control their own health insurance options and not be vulnerable to the changes in the government-run health insurance exchange.


Other brokerages take a cookie cutter approach to insurance and outfit their customers with generic coverage.  Skyline is different.  We believe insurance should be built on innovation and experience. We appreciate the fact that every engagement is unique and understand proper coverage requires a deep understanding of the underlying business and individual.

"The opportunity to safeguard your concerns is a privilege we never take for granted."

ACA Repeal & Tax Returns

ACA Repeal & Tax Returns

On January 20th president Trump signed an executive order, permitting the Department of Health and Human Services to withdraw and repeal certain features of the Affordable Care Act (Obamacare). Prior to this executive order, law under the ACA and the IRS required taxpayers to demonstrate “essential minimum coverage (MEC).” Taxpayers are considered to have MEC if they have health insurance via: Medicaid, Medicare, CHIP, retiree coverage, TRICARE, VA health coverage, or private health insurance purchased from the individual, small group or large group market place. Taxpayers on COBRA or state continuation may also qualify for MEC depending on their plan type.

Taxpayers who do not have MEC are subject to a waiver of exemption or a penalty. This penalty is referred to as the “shared individual responsibility payment.” In 2016, the shared individual responsibility payment for anyone who does not have MEC is 2.5% of your adjusted gross income, or $695 per adult and $347.50 per child, up to a maximum of $2,085, whichever is greater. In 2015, taxpayers without MEC had to pay $325 per adult and $162.50 per child up to $975 per family, or 2% of your household income, whichever was greater.

Results for 2015 aren’t currently available, however in 2014, 7.5 million Americans paid shared individual responsibility payments to the IRS for a total of $1.5 billion in penalties.

Here is the good news, the IRS has recently announced, “Individuals do not have to wait for their Form 1095-B or 1095-C in order to file. While the information on these forms may assist in preparing a return (tax return) they are not required. Like last year (2015), taxpayers can prepare and file their returns using other information about their health insurance.”

The quickest and easiest way for tax payers to indicate that they have coverage is to complete the box on line 61 on page 2 of their individual income tax return:

In 2017, the IRS has said that it will accept and process tax returned even if a taxpayer is silent on coverage. This means that tax payers filing for their tax returned are not obligated to specify their healthcare coverage.

To be clear, this does not mean that tax payers should leave this question on their tax return blank. If possible it is always recommended to complete any IRS document truthfully and to the best of your ability. 

Replacing Obamacare Will Be Harder Than Any Republicans Thought

Replacing Obamacare Will Be Harder Than Any Republicans Thought

President-elect Donald Trump has made many promises as he campaigned for the Presidential election. While no one knows which promises he'll keep and if he'll be able to accomplish many of them, repealing the Affordable Care Act will be difficult. Here's why:

The Repeal

It took President Obama several years to create and complete Obamacare. The system is vast and complex. Plus, it took years just to approve the legislation before any implementation could be completed. Repealing the system is not going to happen overnight.

Millions of people utilize Obamacare. And many Republicans agree that instantly repealing the system could cause a shock to the industry – and not in a good way. No matter what happens, most predict change is inevitable.

Trump could sign a repeal of Obamacare in his first days in office. Then ensure it doesn't go into effect for some time. This would allow Republicans to draft complex plans and policy for the replacement of the Affordable Care Act. Everyone in Congress is confident that repealing the act will be much easier than replacing it.

For example, certain provisions will be included in the new health care laws and mandates. Many Republicans, including Trump, like the age provisions that allows young adults to stay on their parent's insurance plan. Other Republicans are found of provisions that offer guaranteed coverage to all.

Health Insurers & ACA

Health insurance companies are essentially playing a waiting game at this point. The Affordable Care Act was a complete and utter shock to the industry. Many insurers struggled to cope with the various regulations and costs. However, now that the act is in place, things seem to be running smoothly.

Repealing and replacing Obamacare will be anything but smooth. Many health insurance companies are crossing their fingers in hopes of a minor disruption. Most people in the industry don't want to see the shock and chaos that implementing Obamacare brought just a few years back – again!

Getting Into the Details

Obamacare, repealing, and new replacement legislation is going to get tricky. For instance, most believe that guaranteeing coverage for pre-existing conditions is an important piece of legislation. However, many argue that the mandate requiring all Americans to have health coverage is unjust.

Alternatives to the mandate have been discussed. However, most agree that the financial penalties found in the mandate ensure more Americans get coverage. Without the financial penalties, there would be many people who wouldn't buy coverage

Many Republicans, like Speaker of the House Paul Ryan, have proposed similar legislation to Obamacare. He'd like certain people to receive tax incentives to help people afford the type of coverage they need. He's also interested in protecting people from rising rates for illness – when they maintain continuous health insurance coverage.

Breaking Records

While Obamacare has taken certain hits here and there, the people of the United States have hit a record low of uninsured. More people have coverage in the United States than nearly ever before. In this way, the Affordable Care Act was a success.

Not every aspect of Obamacare has been successful, though. Major insurance companies like Aetna and UnitedHealth Group both withdrew from the program. Premiums have skyrocketed, too. Plus, many Obamacare plans feature high deductible – ensuring many couldn't afford care if they got ill.  

The Reality of Obamacare

The Affordable Care Act will be repealed. With Trump as the President and a Republican House and Senate, the legislation doesn't stand a chance. The reality of the situation is this:

Once the bill is repealed, Republicans and Democrats will have to work together to replace the parts of Obamacare that everyone agrees on. It will take time, a lot of time – as that's just how things work in Washington. Hopefully, the time and change won't have too negative of an effect on the health insurance industry and the American public. 

For more information about health insurance contact Skyline Risk Management, Inc. - (718) 267-600.

How the Affordable Care Act Increases Will Affect Consumers

How the Affordable Care Act Increases Will Affect Consumers

Unfortunate news broke the health insurance world in the last month in the form of the announcement of the rising costs of insurance premiums under the Affordable Care Act, also known as Obamacare. These new increases will go into effect in 2017 and plans have increased by as much as 116%. This increase is leaving many Americans currently insured under a plan from the Affordable Care Act feeling confused and dismayed at the idea that their premiums would skyrocket.  However, it appears that the majority will not see a massive increase.

Higher Sticker Prices

It is true that the “sticker price” of insurance premiums are going up an average of 22% across the board. The increase varies based on the state. Some states such as Indiana and Massachusetts will see small decreases of up to 3%, some will see no difference at all, and other states such as Arizona and Pennsylvania will see premium increases of up to 116%.

For those in the states with significant increases, especially, the increase is quite shocking It is understandable that consumers might be surprised and even upset by the news considering that one of the highest priorities of the Affordable Care Act is for insurance to be affordable.  While there will be some consumers sorely affected by the increase, thanks to other provisions of Obamacare, most will not.

More Credits and Deductions

The good news in this situation is that, in correlation with the increases seen in the plan sticker costs, there will also be an increase in the credits and deductions available under the Affordable Care Act.  TheFederal Treasury will fund those deductions, and most consumers who currently have Obamacare will be eligible.  With these deductions, low and mid-level income households should not see a major increase and may not see an increase at all.

Those Who Will be Affected

The group who will be hardest hit by the higher sticker prices will be those individuals who earn more than four times the poverty level.  The amount varies based on your household size, but for an individual that amount is $47,520 and increases from there with additional household members.  Those who earn more than the set amount are not eligible for any subsidies. They will have to pay the full sticker price which could now be more painfully than it was previously.

It is important to note, that the majority of those who currently have an insurance plan purchased under the Affordable Care Act do not meet that level of income.  Because most Obamacare consumers are below four times the poverty line, most will be eligible for the reductions. In fact, 77% of those with plans currently would still be able to pay less than $100 a month.


There is no denying that this increase in premiums under the Affordable Care Act is disappointing.  Some Americans are going to be several affected by these hikes and may be in the same situation they were before, where they can no longer afford insurance. However, as frustrating as seeing an increase in rates can be, the reality is that most consumers insured under Obamacare will not see those increases passed along to them.

Whether these increases will continue, or if there ever will be a relief to those who do not currently qualify for the subsidies, it is uncertain. With new leadership taking over the country, there are sure to be many more changes to the Affordable Care Act to come. How the everyday consumer will be affected in the new round of changes

To voice your concerns contact Skyline Risk Management, Inc. at (718) 267-6600

Insurance, Employment, And A Trump Presidency

Insurance, Employment, And A Trump Presidency


What a year. Trump has been elected as the next President of the United States of America, promising many changes and garnering as much criticism as he has support. What he manages to actually do during the course of his presidency, of course, remains up to time itself. However, as the clock ticks towards his inauguration, here are some of the things he has said he will do regarding insurance, taxes, and the business world.

Trump and Healthcare

One of Trump’s main campaign points was a repeal of the Affordable Care Act. The Affordable Care Act was signed in by President Obama and gave health insurance to 22 million people. That is 10% of the American public who received insurance because of the existence of the Affordable Care Act, where many of them were uninsured before the Act being created.

So far, Trump and his allies have not given the American public any real answers regarding his health care plan, only that he wants to repeal the Affordable Care Act as soon as possible. This leaves the 22 million newly insured Americans with no real course of action should their current health insurance plans become defunct. He has thus far not replied to concerns about the healthcare industry and insurance companies that have benefited from the healthcare market set up by the Affordable Care Act. Trump has said he will provide universal health care coverage, but has not detailed what that will look like. He also wishes to make changes to Medicaid.

Insurance and Employers

Trump’s economic policies also include a repeal of the employer insurance mandate, the medical device tax, and the tax on medical insurers. While there has been considerably less backlash on this topic than on his health care policies, a lack of clarity regarding the future remains. However, the removal of these taxes and laws allows employers and the insurance industry the chance to have a say in the new president’s policies. Hopefully, there are a positive and effective series of policies created from the knowledge of employers and the insurance industry.

The Children’s Health Insurance Program

The future of the Children’s Health Insurance Program is also up in the air with the Trump presidency looming. This particular insurance program was created by Hillary Clinton in the 1990s as part of her time as First Lady of the United States. This program is up for review in 2017, and could put a strain on the relationship between Trump and members of Congress in support of the Children’s Health Insurance Program.

Lower Tax and Decrease Regulations

Growing in specificity and detail are Trump’s proposals regarding taxes and business regulations. Trump has proposed putting a hold on new business regulations and has said that he will ask related federal agencies to rank current business regulations in order of importance.

One of his most outspoken policies that gained the most support for him during his campaign was his promise to cut corporate and overall income taxes. He hopes this will jump start the economy and make up for the money being spent on the current military budget. He has not stated how much he will cut taxes by, and Congress may stall his efforts to change the current rates due to ongoing issues with the national budget.

Looking Ahead

We cannot say for certain what a Trump presidency will bring in terms of changes to the health care system, tax breaks, deregulated business and much more. Congress and various federal bodies, in addition to the outspoken American people, will set the tone for the next four years regardless.

For more information contact: Skyline Risk Management, Inc. at (718) 267-6600

2017 ACA Health Insurance Plan Increases

2017 ACA Health Insurance Plan Increases

2017: ACA Average Plan Increase by State

Alabama - 71%

Alaska - 26%

Arizona - 145%

Arkansas - 1%

California - 5%

Colorado - 12%

Connecticut - 27%

Delaware - 19%

D.C Washington - 22%

Florida - 17%

Georgia - 13%

Hawaii - 32%

Idaho - 27%

Illinois - 48%

Indiana - (-4%)

Iowa - 6%

Kansas - 46%

Kentucky - 3%

Louisiana - 13%

Maine - 19%

Maryland - 24%

Massachusetts - N/A

Michigan - 5%

Minnesota - 55%

Mississippi - 25%

Missouri - 8%

Montana - 32%

Nebraska - 18%

Nevada - 8%

New Hampshire  - 2%

New Jersey - 7%

New Mexico - 39%

New York - 24%

North Carolina - 40%

North Dakota - 9%

Ohio - (-2%)

Oklahoma - 67%

Oregon - 20%

Pennsylvania - 51%

Rhode Island - (-1%)

South Carolina - 29%

South Dakota - 45%

Tennessee - 49%

Texas - 13%

Utah - 20%

Vermont - 5%

Virginia - 7%

Washington - NA

West Virginia - 23%

Wisconsin - 16%

Wyoming - 9%


2017 is certainly going to be a year of decisions. If you are concerned about your health insurance rates for 2017 contact Skyline Risk Management, Inc at (718) 267-6600 to discuss the best health insurance options for you.